[Screening for Salmonella in pregnancy]

National and Regional Health Authorities advise a stool culture in pregnant women before term in order to detect Salmonella carriers, prevent the spread of this microorganism to the newborn and avoid outbreaks of this infection in the nurseries. The Tuscany section of the Italian Association of Obstetricians and Gynecologists decided to test the usefulness of this Salmonella screening. In 7431 pregnant women at the 36th week a stool sample was examined for the presence of Salmonella. The occurrence of diarrhoea in these women was also investigated. The prevalence of Salmonella excretors in our obstetric population was 0.27%. Thirty per cent of the positive women complained of diarrhoea; that means that the risk of being positive in the presence of this symptom is 11.8 times larger. The positive cases were detected essentially in late summer and fall. No nursery outbreak occurred during the period studied. The Salmonella-carrying mother can not take advantage of an effective antimicrobic therapy and a single stool sample allows the detection of only part of the carriers. Therefore screening can not prevent the possibility of transmission during birth. The unfavorable ratio between costs and benefits suggests that stool culture for Salmonella may be useful only in late summer and fall and in symptomatic women. In order to obtain better results in the prevention of infections among newborns the observance of careful hygienic rules in the delivery rooms and in the nurseries is mandatory.